THE NEW ENGLAND HELLENIC MEDICAL AND DENTAL SOCIETY, Inc.
Established 1973 - Tax Exempt 1986

PO Box 120028, Boston, MA 02112
A non-profit organization representing physicians, dentists and allied health professionals
_____________________________________________________________

MEMBERSHIP AND DUES FORM Year: 2003

Membership Dues: (Please circle and enclose check for the right amount)

Name: ______________________________________________________________________

Title: ________________________________________________________________________

Graduate or Professional School: ____________________________________Year ______

Specialty (if any): _________________________________________

Address/Phone/Fax/E-mail:(Please use an (*) to indicate preferred mailing address)

Home Address: ____________________________________ Phone: _____________ Fax: ___________

Office Address: ____________________________________ Phone: _____________ Fax: ___________

E-mail: ____________________________________

If you would like to help the society, circle your preference below:

1. Social Activities Committee	3. Nominating Committee
2.  Fund Raising Committee	4. Scholarship Committee
5. Other (please specify): ______________________________

Board of Directors

President : Maria Hatziilia, MD	617-254-1282	Members:
Vice-president: Meletia Laskou, DDS	617-292-7746
Vice-president: Pauline C. Pappas, MD	617-472-2709	James Alex, MD
Secretary : Efi Kokkotou, MD, PhD	617-738-7603	Polyxeni Koutkia-Mylonakis, MD
Secretary : Anastasia Koniaris, MD	617-945-4550	George Kroumpouzos, MD
Treasurer : Alexander Georgakis,MD	617-571-1772	Nicholas A Tritos, MD, DSc